A nursing unit is undergoing changes to accommodate new bariatric services that will be available on the unit. Some staff members have verbalized displeasure with the changes. Which of the following actions should the charge nurse take?
Role model a positive approach to the changes.
Redirect the conversation when staff members make negative comments about the changes.
Encourage staff members who support the changes to discuss the issue with resistant staff.
Suggest that resistant staff members transfer to a different unit.
Reprimand staff members who are resistant to the changes.
Correct Answer : A,C
The correct answers are Choices A and C.
Choice A rationale: Modeling positivity leverages social learning and transformational leadership, sets constructive norms, reduces uncertainty, and promotes psychological safety, facilitating Lewin’s change movement and sustained adoption of bariatric workflows and equipment safely.
Choice B rationale: Redirecting negativity suppresses concerns, undermines just culture, and blocks feedback necessary for Lewin’s unfreezing, reducing trust, psychological safety, and data to address barriers, thereby entrenching covert resistance to change process.
Choice C rationale: Engaging supportive peers utilizes diffusion of innovations and social proof; peer dialogue surfaces practical barriers, shares tacit knowledge, normalizes change behaviors, and increases motivation and adherence to bariatric care practices.
Choice D rationale: Suggesting transfers is coercive and punitive, contradicting transformational leadership and just culture, damages morale and retention, bypasses root-cause analysis, and fails to address legitimate change barriers or build sustainable engagement.
Choice E rationale: Reprimanding resistance pathologizes normal adaptation, undermines psychological safety and voice, increases turnover intentions, entrenches oppositional behavior, and conflicts with evidence-based change management; reserve discipline for misconduct, not expressed skepticism alone.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Answer is c. Receiving moderate sedation.
a. Removal of staples from a surgical wound: This procedure is typically considered routine and minimally invasive, involving the removal of staples used for wound closure. While it involves physical manipulation of the wound site, it does not carry significant risks or require the alteration of the patient's consciousness. Therefore, obtaining informed consent for this procedure is not typically necessary as it falls within the standard of care for post-operative wound management.
b. Providing a sputum specimen: Collecting a sputum specimen is a non-invasive procedure commonly performed to aid in the diagnosis of respiratory conditions such as infections or chronic lung diseases. It involves expectorating mucus from the respiratory tract, which does not pose significant risks to the patient. As such, informed consent is usually not required for this procedure since it is relatively simple and does not involve any invasive interventions or alteration of consciousness.
c. Receiving moderate sedation: Correct. Moderate sedation involves the administration of drugs, typically benzodiazepines or opioids, to induce a state of decreased consciousness and relaxation while maintaining the patient's ability to respond to verbal commands and physical stimulation. This procedure carries inherent risks, including respiratory depression, cardiovascular complications, and potential allergic reactions to the medications used. Due to the potential for adverse effects and the altered state of consciousness induced by moderate sedation, informed consent is necessary to ensure that patients understand the risks and benefits of the procedure before it is performed.
d. Collection of a blood specimen for ABGs: Arterial blood gas (ABG) analysis involves the collection of a blood sample from an artery, typically the radial artery in the wrist, to assess the patient's acid-base balance, oxygenation status, and ventilation. While this procedure does involve puncturing the skin and accessing the arterial blood supply, it is considered a standard diagnostic test in many clinical settings. However, the invasiveness of the procedure and potential risks such as bleeding, hematoma formation, and arterial injury may necessitate informed consent in certain situations, especially if the patient has underlying coagulopathies or other risk factors that could increase the likelihood of complications.
Correct Answer is B
Explanation
The correct answer is choice B: "Ask the client to explain the procedure that is being performed."
Choice A rationale:
While verifying that the client understands the risks of the surgery (Choice A) is important, the question specifically asks about verifying informed consent. Informed consent involves ensuring that the patient comprehends the procedure being performed, its benefits, risks, and alternatives. While understanding the risks is a part of this, it's not the complete picture.
Choice B rationale:
The correct response is "Ask the client to explain the procedure that is being performed." This approach ensures that the client truly comprehends the procedure and its implications. If the client can accurately explain the procedure, it indicates a better understanding of what they are consenting to, which aligns with the concept of informed consent.
Choice C rationale:
Answering the client's questions about the outcomes of the surgery (Choice C) is important for providing education and addressing concerns, but it doesn't directly verify informed consent. The focus of informed consent is on the procedure itself, including its nature, purpose, and potential risks.
Choice D rationale:
Determining if the client understands the benefits of the procedure (Choice D) is only part of the informed consent process. While understanding the benefits is essential, it's equally important to ensure the client comprehends the risks and alternatives, which is better assessed by having the client explain the procedure.
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